Session Information
Session Time: None. Available on demand.
Disclosures: Samuel W. Onusko: No financial relationships or conflicts of interest
Objective: To safely implement the Frazier Free Water Protocol (FFWP) in appropriate patients experiencing dysphagia with the aim of improving their self-perception of swallowing and quality of life.
Design: Patients were provided with a 10-point abridged version of the validated Swallowing Quality of Life (SWAL-QOL) questionnaire to assess quality of life at time of rehabilitation admission. The FFWP was then implemented throughout their hospital admission. Patients were re-assessed at discharge with the abridged SWAL-QOL (primary outcome). Discharge diet and incidence of aspiration pneumonia (secondary outcomes) were also documented.
Setting: Inpatient Rehabilitation Hospital
Participants: Inpatient rehabilitation patients with diagnoses of stroke, spinal cord injury, or traumatic brain injury with resulting dysphagia.
Interventions: Frazier Free Water Protocol
Main Outcome Measures: Primary outcome: Abridged SWAL-QOL. Secondary outcomes: discharge diet and incidence of aspiration pneumonia
Results: 14 patients were enrolled in the study between July 1st, 2021 and January 1st, 2022. Of those, 7 patients completed both the admission and discharge questionnaire, 6 completed only the admission questionnaire, and 1 was still admitted at the end of the study. All 7 patients who completed the study reported higher scores on the SWAL-QOL assessment, indicating an improvement in perceived quality of life. The mean improvement in SWAL-QOL scores was 13.5 (SD ± 5.8). Six of the 7 patients were able to tolerate a less restrictive diet at the time of hospital discharge, including 4 patients that were progressed to a regular consistency diet with thin liquids. There were no identified occurrences of aspiration pneumonia while admitted to inpatient rehabilitation in patients enrolled in the study.
Conclusions: The implementation and use of the FFWP in patients with dysphagia who are admitted to the acute rehabilitation setting may improve the perceived quality of life of patients while not contributing significantly to the risk of developing aspiration pneumonia.
Level of Evidence: Level IV
To cite this abstract in AMA style:
Onusko SW, Zakel J, Shitia M. Implementation of the Frazier Free Water Protocol in Acute Rehabilitation Patients with Oropharyngeal Dysphagia and Its Effect on Patient Perception of Swallowing [abstract]. PM R. 2022; 14(S1)(suppl 1). https://pmrjabstracts.org/abstract/implementation-of-the-frazier-free-water-protocol-in-acute-rehabilitation-patients-with-oropharyngeal-dysphagia-and-its-effect-on-patient-perception-of-swallowing/. Accessed May 17, 2025.« Back to AAPM&R Annual Assembly 2022
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/implementation-of-the-frazier-free-water-protocol-in-acute-rehabilitation-patients-with-oropharyngeal-dysphagia-and-its-effect-on-patient-perception-of-swallowing/